Anti-D administration after spontaneous miscarriage for preventing Rhesus alloimmunisation
Cochrane Reviews,  Review Article

Karanth L. et al – To assess the effects of administering anti–D immunoglobulin (Ig) after spontaneous miscarriage in a Rh–negative woman, with no anti–D antibodies. It was concluded that there ais insufficient data available to evaluate the practice of anti–D administration in an unsensitised Rh–negative mother after spontaneous miscarriage. Thus, until high–quality evidence becomes available, the practice of anti–D Immunoglobulin prophylaxis after spontaneous miscarriage for preventing Rh alloimmunisation cannot be generalised and should be based on the standard practice guidelines of each country.

Methods

  • The authors searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 December 2012).
  • Randomised controlled trials (RCT) in Rh–negative women without antibodies who were given anti–D Ig following spontaneous miscarriage compared with no treatment or placebo treatment following spontaneous miscarriage as control were included.
  • Two review authors independently assessed trials for inclusion and trial quality. Two review authors extracted data and checked it for accuracy.
  • The study included one RCT, involving 48 women who had a miscarriage between eight to 24 weeks of gestation.
  • Of the 19 women in the treatment group, 14 had therapeutic dilatation & curettage (D&C) and five had spontaneous miscarriage; of the 29 women in the control group, 25 had therapeutic D&C and four had spontaneous miscarriage.
  • The treatment group received 300 µg anti–D Ig intramuscular injection and were compared with a control group who received 1 cc homogenous gamma globulin placebo.

Results

  • This review's primary outcomes (development of a positive Kleihauer Betke test (a test that detects fetal cells in the maternal blood; and development of RhD alloimmunisation in a subsequent pregnancy) were not reported in the included study.
  • Similarly, none of the review's secondary outcomes were reported in the included study: the need for increased surveillance for suspected fetal blood sampling and fetal transfusions in subsequent pregnancies, neonatal morbidity such as neonatal anaemia, jaundice, bilirubin encephalopathy, erythroblastosis, prematurity, hypoglycaemia (low blood sugar) in subsequent pregnancies, maternal adverse events of anti–D administration including anaphylactic reaction and blood–borne infections.
  • The included study did report subsequent Rh–positive pregnancies in three women in the treatment group and six women in the control group. However, due to the small sample size, the study failed to show any difference in maternal sensitisation or development of Rh alloimmunisation in the subsequent pregnancies.

Please login or register to follow this author.
Are you sure you want to Unfollow this Author?
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Obstetrics & Gynecology

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Obstetrics & Gynecology Articles

1 The effect of chromium supplementation on polycystic ovary syndrome in adolescents Journal of Pediatric and Adolescent Gynecology , May 30, 2014    Clinical Article

2 Oral antihypertensive therapy for severe hypertension in pregnancy and postpartum: A systematic review BJOG: An International Journal of Obstetrics and Gynaecology, June 5, 2014    Evidence Based Medicine    Review Article

3 Oophorectomy and hysterectomy and cancer incidence in the cancer prevention study-II nutrition cohort Obstetrics and Gynecology, June 4, 2014    Clinical Article

4 High-dose vaginal metronidazole for recurrent bacterial vaginosis: A pilot study Journal of Lower Genital Tract Disease, April 3, 2014    Clinical Article

5 Vitamin D and menopause-A narrative review Maturitas, June 25, 2014    Review Article

6 Maternal consumption of dairy products, calcium, and vitamin D during pregnancy and infantile allergic disorders Annals of Allergy, Asthma, and Immunology, June 20, 2014    Clinical Article

7 The correlation between vitamin D level and primary cesarean section Full Text Middle East Journal of Family Medicine, June 11, 2014    Free full text    Clinical Article
Exclusive Author Commentary

8 Trends in glyburide compared with insulin use for gestational diabetes treatment in the United States, 2000-2011 Obstetrics and Gynecology, June 2, 2014    Clinical Article

9 Do statins increase and Mediterranean diet decrease the risk of breast cancer? Full Text BMC Medicine, June 19, 2014    Free full text

10 Utilization of the combined tetanus-diphtheria and pertussis vaccine during pregnancy American Journal of Obstetrics and Gynecology, June 6, 2014    Clinical Article

11 Mid-pregnancy vitamin D levels and postpartum depression European Journal of Obstetrics & Gynecology and Reproductive Biology, June 17, 2014    Clinical Article

12 Risk of breast cancer recurrence associated with carbohydrate intake and tissue expression of IGFI receptor Cancer Epidemiology, Biomarkers & Prevention, June 16, 2014    Clinical Article

13 Dietary protein sources in early adulthood and breast cancer incidence: prospective cohort study BMJ, June 24, 2014    Evidence Based Medicine    Clinical Article

14 Polymorphisms in vitamin D-related genes and risk of uterine leiomyomata Fertility and Sterility, June 9, 2014    Clinical Article

15 Breast cancer risk in older women: Results from the NIH-AARP Diet and Health Study Cancer Causes and Control, May 13, 2014    Clinical Article

16 The utility of ultrasound surveillance of fluid and growth in obese women American Journal of Obstetrics and Gynecology, June 26, 2014    Clinical Article

17 First-trimester exposure to metformin and risk of birth defects: A systematic review and meta-analysis Human Reproduction Update, June 12, 2014    Clinical Article

18 Effect of docosahexaenoic acid-enriched fish oil supplementation in pregnant women with Type 2 diabetes on membrane fatty acids and fetal body composition—double-blinded randomized placebo-controlled trial Diabetic Medicine, June 13, 2014    Clinical Article

19 Use of music to reduce anxiety during office hysteroscopy: Prospective randomized trial Journal of Minimally Invasive Gynecology, June 3, 2014    Clinical Article

20 High-dose vitamin D supplementation and measures of insulin sensitivity in polycystic ovary syndrome: A randomized, controlled pilot trial Fertility and Sterility, May 6, 2014    Clinical Article

Indexed Journals in Obstetrics & Gynecology: Obstetrics and Gynecology, American Journal of Obstetrics and Gynecologymore

Register now to view all the MDLinx contents (FREE)!

  • Stay current on the latest literature, research and clinical news
  • Get special communications and offers from MDLinx and our sponsors
  • Receive invitations to paid market research
View Samples and Register

Connect with us, stay current.

Receive the latest mecial news
updates for free via email

Sign up!

Subscribe to our free RSS feeds:

Get the latest news in your specialty automatically added to your newsreader or your personal My Yahoo!, Google, My MSN or My AOL page. Learn More

Close